John, after mapping you have to activate Direct Trust. Below is the email Updox sent me:
Your practice does not have an active Direct email address because you have not completed the Direct Trust Activation. Once you have completed this vetting process, you can begin using Direct email. This is HIPAA compliant, provider to provider email. Your direct sub domain can be alicecoghillmd.amazing-direct.com. Users will have direct user names to come before the @.
To access the Direct Trust Activation, log in to Updox web application (ui.myupdox.com). Then follow Menu, Tools, Direct Trust Activation.If you have further questions, please let me know.
Thank you!
Maureen Stilwell | Customer Experience Analyst |
http://support.updox.com 
